CLAYMAN and Frank have tackled an interesting, important, and potentially impossible topic. The problem, I fear, is lack of adequate data to truly resolve the issue. I am a proponent of elective neck dissections in patients at risk of having occult metastases from primary sites in the upper respiratory and digestive tracts. The histological evaluation thus afforded provides invaluable information to the patient and the treatment team regarding prognosis and the potential need for adjuvant therapy. At the conclusion of the 20th century, this is the best we can do to "biologically stage" these patients.